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HomeMy WebLinkAboutInsurance Certificate: Pape Machinery Inc ® CERTIFICATE OF LIABILITY INSURANCE DATE/2014 YYYY) ACORO DATE 03/03/2014 2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA INC. NAME: 111 SW COLUMBIA, STE. 500 PHONE p/C No : PORTLAND, OR 97201 E-MAIL Attn: Liz Whiting 503-248-1204 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC N 900810-STND-GAWU-14-15' PM INSURER A: National Union Fire Insurance Company 19445 INSURED WA WA PAPE MACHINERY, INC. INSURER B: CIO THE PAPE GROUP INSURERC: N/A WA PO BOX 407 INSURER D: WA WA EUGENE, OR 97440 INSURER E: WA WA INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-001998348-35 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AODLUBR TYPE OF INSURANCE POLICY NUMBER MMIDD/Y E LTR YYY MWDDfYY`f LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY GL 4309787 0310112014 0310112015 PREMISES EaEoccurmnce $ 250,000 CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 25,000 X CONTRACTUAL LIAR PERSONAL B ADV INJURY $ 1,000,000 X PERLOCAGG$2M GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 X POLICY PRO- LOC $ A AUTOMOBILE LIABILITY CA 3482083 03101/2014 0310112015 COMBINED SINGLE LIMIT 2,000,000 Ea eccid.nt Ix ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS X AUT SEED Perr acEcRWen DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI RETENTION$ , $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE❑ NIA E.L. EACHACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE -EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarlu Schedule, if more space Is required) RE: THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS WHEN REQUIRED BY WRITTEN AGREEMENT OR CONTRACT AS RESPECTS TO OPERATIONS OF THE NAMED INSURED. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 EAST MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Elizabeth A. Whiting fiiz.Le7i. 4.410V'A3r , ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD